3 March 2005 – LAWFUEL – The Law News Network – Marcos Daniel Jiménez, United States Attorney for the Southern District of Florida; Michael S. Clemens, Special Agent in Charge, Federal Bureau of Investigation; Linda S. Little, Special Agent in Charge, United States Department of Health and Human Services, Office of the Inspector General, Criminal Investigations; and Brian Wimpling, Special Agent in Charge, Internal Revenue Service, Criminal Investigations, announced today that two (2) defendants were convicted by a federal jury, after a three-week trial before United States District Court Judge Cecilia M. Altonaga, in Miami, Florida, bringing the total number of convictions to twelve (12), in a multi-million dollar Medicare fraud and money laundering scheme involving local durable medical equipment (“DME”) companies that fraudulently submitted false claims to Medicare with respect to expensive custom-made orthotic devices such as knee, shoulder, and hip braces.
Convicted today by a federal jury were defendants, Stephanie Smith, who owned a medical clinic and supplied false prescriptions which were used in the fraudulent scheme, and Miraidy Gonzalez, who worked at the billing company which created fake patient files and submitted the false claims to Medicare. Smith and Gonzalez were convicted of one (1) count of conspiring together and with others to commit health care fraud. Smith also was convicted of three (3) counts of soliciting and receiving kickbacks in return for the referral of patients for which payments were made in whole or in part by the Medicare Program. Both Smith and Gonzalez were convicted of one (1) count of conspiracy to commit money laundering, and each defendant was convicted of a substantive money laundering count.
In addition to Smith and Gonzalez, this prosecution resulted in the convictions (through guilty pleas) of ten (10) other defendants on such charges as conspiracy to defraud Medicare, in violation of 18 U.S.C. § 371; healthcare fraud, in violation of 18 U.S.C. § 1347; conspiracy to commit money laundering, in violation of Title 18 U.S.C. § 1956(h); money laundering, in violation of 18 U.S.C. § 1956; and structuring financial transactions to avoid bank reporting requirements, in violation of 31 U.S.C. §5324(a)(3).
Specifically, Ruben Martinez; his daughter, Adriana Ramos; her husband, Daniel Ramos; Ruben Martinez’s son, Daniel Martinez; and Ruben Martinez’s mother, Edith Martinez,
previously pleaded guilty to conspiracy to commit health care fraud and conspiracy to launder money. All of them owned and controlled more than twelve (12) DME companies involved in the fraudulent scheme.
Hilda Garcia, who conspired with the Ramos and Martinez family members while working as a customer service representative at Union Planters Bank, Michel Mari, a “straw” owner of one of the DME companies, and Armando Domas, a check cashier who paid kickbacks to Medicare patients previously pleaded guilty to conspiring to structure financial transactions.
Clara Cardelle, a patient recruiter who supplied the Ramoses and Miraidy Gonzalez with Medicare patient information so that they may be used in the false claims, previously pleaded guilty to health care fraud.
Finally, Marcos Duran, an accountant who assisted the Ramos and Martinez families file false tax returns and hide the Medicare money, previously pleaded guilty to tax fraud.
Emilio Seijo, a life-long friend of the Martinez and Ramos families and who was involved in the money laundering conspiracy, was charged and remains a fugitive.
As alleged in the initial Indictment and Superseding Indictment, the conspirators recruited individuals to serve as “straw owners” of the DME companies in order to conceal the conspirators’ involvement in the companies. The conspirators then used the companies to fraudulently bill Medicare for expensive custom-made orthotic devices, and other medical services, that were neither provided to nor needed by Medicare patients. Also alleged was that the defendants paid kickbacks to patient recruiters who would, in turn, bribe Medicare beneficiaries to serve as fictitious patients for the medical equipment companies. From about January 2000 through December 2002, the medical equipment companies received approximately $17 million in Medicare payments, all of which were reimbursements for false claims relating to orthotic devices and other medical equipment such as oxygen tanks and hospital beds.
All the medical equipment companies closed in December 2002. That same month, the United States Attorney’s Office filed a civil injunctive action and was eventually able to freeze approximately $900,000 held in bank accounts connected with the Martinez and Ramos family members.
Those defendants convicted of the health care fraud conspiracy face a maximum statutory term of imprisonment of five (5) years. The money laundering conspiracy and its related money laundering convictions are all punishable by a maximum statutory term of imprisonment of twenty (20) years. Finally, the structuring conspiracy conviction carries a maximum statutory term of imprisonment of five (5) years. All the defendants, other than Stephanie Smith and Miraidy Gonzalez, are scheduled to be sentenced at the end of March 2004. Smith and Gonzalez are scheduled to be sentenced in May 2004.
Mr. Jiménez commended the investigative efforts of the Federal Bureau of Investigation, the United States Department of Health and Human Services, and the Internal Revenue Service. The criminal prosecution is being handled by Assistant United States Attorneys Wifredo A. Ferrer and E.J. Yera, with assistance from Assistant United States Attorney Allyson Fritz on the asset forfeiture charges. The civil lawsuit was handled by Assistant United States Attorney Lisa Barquist.
A copy of this press release may be found on the website of the United States Attorney’s Office for the Southern District of Florida at www.usdoj.gov/usao/fls. Related court documents and information may be found on the website of the District Court for the Southern District of Florida at www.flsd.uscourts.gov or on http://pacer.flsd.uscourts.gov.